Individual
BLAKE SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
84 W SOUTH ST, WILKES BARRE, PA 18766-0997
(607) 372-1789
Mailing address
1339 SW 181ST AVE, PEMBROKE PINES, FL 33029-4904
(607) 372-1789
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11038266
FL
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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